Ibrance (palbociclib) is a prescription drug used to treat breast cancer in certain adults. It comes as an oral tablet and oral capsule. Ibrance can interact with certain supplements and medications, including dronabinol (Marinol, Syndros).
An interaction can occur because one substance causes another substance to have a different effect than expected. Interactions can also occur if you have certain health conditions.
Before you start taking Ibrance, tell your doctor and pharmacist about any prescription, over-the-counter, or other drugs you take. Sharing this information with them may help prevent possible interactions. (To learn whether Ibrance interacts with herbs or vitamins and supplements, see the “Are there other interactions with Ibrance?” section below.)
If you have questions about drug interactions that may affect you, talk with your doctor or pharmacist.
The table below lists drugs that may interact with Ibrance. Keep in mind that this table does not include all drugs that may interact with Ibrance. For more information about some of these interactions, see the “Drug interactions explained” section below.
| Drug group or drug name | Drug examples | What can happen |
| clarithromycin | — | can increase the risk of side effects from Ibrance |
| rifampin (Rifadin, Rimactane) | — | can make Ibrance less effective |
| zolpidem (Ambien, Edluar) | — | can increase the risk of side effects from zolpidem |
| dronabinol (Marinol, Syndros) | — | can increase the risk of side effects from dronabinol |
| certain antifungals | • ketoconazole • itraconazole (Sporanox, Tolsura) • voriconazole (Vfend) • posaconazole (Noxafil) | can increase the risk of side effects from Ibrance |
| certain seizure drugs | • carbamazepine (Carbatrol, Tegretol, others) • phenytoin (Dilantin, Phenytek) • fosphenytoin (Cerebyx) | can make Ibrance less effective |
| certain benzodiazepines | • alprazolam (Xanax, Xanax XR) • midazolam (Nayzilam, Seizalam) • triazolam (Halcion) | can increase the risk of side effects from the benzodiazepine |
| certain immunosuppressant drugs | • cyclosporine (Gengraf, Neoral, others) • everolimus (Afinitor, Zortress) • tacrolimus (Astagraf XL, Prograf, others) • sirolimus (Fyarro, Rapamune) | can increase the risk of side effects from the immunosuppressant |
| certain antipsychotics | • clozapine (Clozaril, Versacloz) • haloperidol (Haldol) • pimozide | can increase the risk of side effects from the antipsychotic |
| certain opioids | • fentanyl (Actiq, Fentora, others) • hydrocodone (Hysingla ER) • oxycodone (Oxycontin, Roxicodone, others) • tramadol (Conzip, Qdolo) | can increase the risk of side effects from the opioid |
Ibrance is not known to interact with alcohol. But Ibrance and alcohol can cause some similar side effects, such as fatigue, nausea, and vomiting. So you may be more likely to experience these side effects if you drink alcohol during your Ibrance treatment.
If you have questions about consuming alcohol while taking Ibrance, talk with your doctor or pharmacist.
Learn more about certain drug interactions that can occur with Ibrance.
Interaction with clarithromycin
Ibrance can interact with clarithromycin, which is used to treat bacterial infections.
What could happen
Clarithromycin may affect how your body breaks down Ibrance. This can lead to a high level of Ibrance in your system, which increases your risk of side effects.
What you can do
If you take Ibrance with clarithromycin, your doctor may prescribe a lower dosage of Ibrance for you. You should not take a higher dose of either medication than your doctor prescribes.
If you have questions about taking Ibrance with clarithromycin, talk with your doctor or pharmacist.
Interaction with dronabinol
Ibrance can interact with dronabinol (Marinol, Syndros). Dronabinol is prescribed for nausea and vomiting or low appetite in certain people.
What could happen
Taking Ibrance with dronabinol can raise your risk of side effects from dronabinol. Ibrance could slow down the activity of an enzyme that breaks down dronabinol in your system. This can lead to a high level of dronabinol in your body, which could raise your risk of side effects.
What you can do
If you take Ibrance with dronabinol, watch for side effects such as dizziness and sleepiness. Your doctor can advise you on how to manage these side effects. They can also determine whether you should stop taking either drug. (But you should not stop taking either drug without first talking with your doctor.)
If you have questions about taking Ibrance with dronabinol, talk with your doctor or pharmacist.
Interaction with certain opioids
Ibrance can interact with certain opioids, which are used to treat pain.
Examples of opioids that may interact with Ibrance include:
- fentanyl (Actiq, Fentora, others)
- hydrocodone (Hysingla ER)
- oxycodone (Oxycontin, Roxicodone, others)
- tramadol (Conzip, Qdolo)
What could happen
Taking Ibrance with certain opioids could increase your risk of side effects from the opioid. This is because Ibrance slows down the activity of an enzyme that breaks down these opioids in your body. As a result, the level of the opioid in your system may be high, which could lead to side effects from the drug.
What you can do
Doctors may prescribe opioids for cancer pain, including that of breast cancer. (Ibrance is used to treat breast cancer in certain adults.) If needed, your doctor can recommend an opioid that’s safe to take with Ibrance.
If you take Ibrance with an opioid, your doctor may prescribe a lower dosage of the opioid for you. You should not take a higher dose of either medication than your doctor prescribes.
If you’re taking Ibrance with an opioid it may interact with, do not stop taking Ibrance without first talking with your doctor. In some cases, suddenly stopping Ibrance could increase your risk of opioid withdrawal. This is because your body would break down fentanyl more quickly without the presence of Ibrance. This could result in you having lower levels of fentanyl in your body, which raises your risk of opioid withdrawal.
If you need to stop taking Ibrance, tell your doctor right away if you have symptoms of opioid withdrawal. These may include body aches, runny nose, and abdominal pain. Your doctor can recommend what to do if you have these symptoms.
If you have questions about taking Ibrance with an opioid, talk with your doctor or pharmacist.
Ibrance may have other interactions. They could occur with supplements, foods, vaccines, or even lab tests. See below for details. Note that the information below does not include all other possible interactions with Ibrance.
Does Ibrance interact with supplements?
Before you start taking Ibrance, talk with your doctor and pharmacist about any herbs or vitamins and supplements you take. Sharing this information with them may help you avoid possible interactions.
If you have questions about interactions that may affect you, talk with your doctor or pharmacist.
Ibrance interactions with herbs
Ibrance can interact with St. John’s wort, which is used to ease symptoms of depression and other conditions.
St. John’s wort may speed up the activity of an enzyme that breaks down Ibrance in your body. This can lower the level of Ibrance in your system, making the drug less effective.
Your doctor can recommend an alternative to St. John’s wort for your condition.
Ibrance and vitamins
There are currently no reports of Ibrance oral tablets or oral capsules interacting with vitamins. But this doesn’t mean that vitamin interactions won’t be recognized in the future.
For this reason, it’s still important to check with your doctor or pharmacist before taking any of these products while taking Ibrance.
Does Ibrance interact with food?
Ibrance may interact with grapefruit or grapefruit juice. Taking the drug with grapefruit products could cause your body to break down Ibrance more slowly than usual. This can increase the level of Ibrance in your system, raising your risk of side effects from the drug.
If you have questions about eating specific foods during your treatment with Ibrance, talk with your doctor.
Does Ibrance interact with vaccines?
It may not be safe to receive certain vaccines while you’re taking Ibrance. Examples include vaccines for COVID-19 (Comirnaty, Spikevax), cholera (Vaxchora), and dengue (Dengvaxia).
This is because Ibrance may lower the activity of your immune system. These vaccines work by helping the immune system recognize the conditions they protect against. Getting these vaccines while taking Ibrance could make the vaccines less effective.
Before taking Ibrance, ask your doctor to review your vaccine history. Your doctor can tell you which vaccines may be safe to receive while you’re taking Ibrance.
If you have questions about getting specific vaccines during your Ibrance treatment, talk with your doctor.
Does Ibrance interact with lab tests?
There are currently no reports of Ibrance oral tablets or oral capsules interacting with lab tests. If you have questions about having certain lab tests during your treatment with Ibrance, talk with the healthcare professional ordering the test.
Does Ibrance interact with cannabis or CBD?There are currently no reports of interactions with Ibrance oral tablets or oral capsules and cannabis (commonly called marijuana) or cannabis products. An example of a cannabis product is cannabidiol (CBD). But as with any drug or supplement, talk with your doctor before using cannabis with Ibrance.
Note: Cannabis is illegal at a federal level but is legal in many states to varying degrees.
Certain medical conditions or other health factors may raise the risk of interactions with Ibrance. Before taking Ibrance, talk with your doctor about your health history. They’ll determine whether Ibrance is right for you.
Health conditions or other factors that might interact with Ibrance include:
Severe liver problems. Before taking Ibrance, tell your doctor if you have a severe liver problem, such as liver failure. They may prescribe a lower dosage of Ibrance for you.
Pregnancy. Ibrance is not safe to take during pregnancy. If you’re pregnant or planning a pregnancy, talk with your doctor before taking Ibrance.
Breastfeeding. It’s not known whether Ibrance is safe to take while breastfeeding or whether it passes into breast milk. But because of the risk of serious side effects, breastfeeding is not recommended during your Ibrance treatment. If you’re breastfeeding or planning to breastfeed, talk with your doctor about your options.
Allergic reaction. If you’ve had an allergic reaction to Ibrance or any of its ingredients, your doctor will likely not prescribe Ibrance. This is because taking the drug could cause another allergic reaction. You can ask your doctor about other treatments that may be better choices for you.
Find answers to some frequently asked questions about Ibrance and possible interactions.
Do Ibrance and turmeric interact?
It’s possible that Ibrance and turmeric may interact, but this isn’t known for certain. Turmeric is a herb that can be used for several purposes, including possible uses for breast cancer. (Ibrance is used to treat breast cancer in certain adults.)
Some research suggests that turmeric may slow down the activity of an enzyme (protein) that breaks down Ibrance in your body. But this interaction wasn’t seen in studies of Ibrance oral tablets or oral capsules.
Before taking Ibrance with turmeric, talk with your doctor or pharmacist. They can help determine whether it’s safe to take them together.
What medications can you not take with Ibrance?
Whether Ibrance can be taken with certain other medications depends on the possible interaction between the drugs. Your doctor will consider the possible effects of the interaction. They’ll advise whether certain drugs should not be taken with Ibrance or if they may be taken with caution.
For example, taking Ibrance with certain opioids can increase the risk of side effects from the opioid. But doctors may still prescribe them together. To learn more about this, see the “Drug interactions explained” section above.
If you have other questions about drugs you should not take with Ibrance, talk with your doctor or pharmacist.
Taking certain steps can help you avoid interactions with Ibrance. Before starting treatment, talk with your doctor and pharmacist. Things to discuss with them include:
- whether you drink alcohol or use cannabis
- other medications you take, as well as any vitamins, supplements, and herbs (they can also help you fill out a
medication list ) - what to do if you start taking a new drug during your Ibrance treatment
It’s also important to understand Ibrance’s
If you have trouble reading or understanding this information, your doctor or pharmacist can help.
Taking Ibrance exactly as prescribed can also help prevent interactions.
Disclaimer: Healthline has made every effort to make certain that all information is factually correct, comprehensive, and up to date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or another healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.